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Biomedical subjects

L Ravizza

Publications and source records attributed to L Ravizza.

At least 19 recordsLinked to original sources
PubMed1996

A double-blind comparison of venlafaxine and fluoxetine for treatment of major depression in outpatients.

1. This was a randomized, double-blind comparison of the efficacy and safety of venlafaxine and fluoxetine in outpatients with major depression. 2. Three hundred fourteen patients were randomly assigned to either venlafaxine 37.5 mg twice daily or fluoxetine 20 mg once daily for a maximum of 8 weeks. 3. If the response was inadequate after two weeks of treatment, the dosage of venlafaxine could be increased to 75 mg twice daily. 4. A clinical response, defined as at least a 50% decrease from baseline in the total HAM-D score, was attained at week 6 in 72% of patients on venlafaxine and 60% of patients on fluoxetine (p = 0.023). 5. Among patients who increased their dose at 2 weeks, venlafaxine was significantly (p < 0.05) superior from week 3 onward on the HAM-D. 6. Venlafaxine 75 mg daily is comparable to fluoxetine, but at 150 mg daily, it may be superior to fluoxetine in outpatients with major depression who do not respond early to treatment.

Adult↗
PubMed1995

Type I and type II schizophrenia: relations between tonic electrodermal activity and clinical ratings before and after haloperidol treatment.

To test the hypothesis that schizophrenic patients with positive vs. negative symptoms show different tonic electrodermal patterns, 26 patients with Type I schizophrenia and 19 patients with Type II schizophrenia were evaluated before and after 2 weeks of haloperidol treatment (standard daily dose = 4.5 mg). Clinical assessments were made with the Brief Psychiatric Rating Scale, the Scale for the Assessment of Positive Symptoms, and the Scale for the Assessment of Negative Symptoms. Skin conductance level (SCL) and spontaneous fluctuations (SF) frequency were recorded for each patient. Before treatment, Type I patients showed higher SCL and SF compared with Type II patients; after treatment, a significative decrease of clinical and psychophysiological variables was found only in Type I patients.

Adolescent↗
PubMed1995

Predictors of drug treatment response in obsessive-compulsive disorder.

BACKGROUND: Although a large body of evidence indicates the efficacy of pharmacotherapy in the treatment of obsessive-compulsive disorder (OCD), a considerable percentage of these patients do not respond. Very few studies focus on factors related to treatment response of OCD. The purpose of this study was to investigate which clinical factors are related to drug treatment response in OCD. METHOD: We examined 53 OCD patients treated with either clomipramine or fluoxetine for a period of 6 months, dividing the sample into "responders" and "nonresponders" to treatment. At admission, patients were evaluated using a semistructured clinical interview, the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Hamilton Rating Scale for Depression, and the Hamilton Rating Scale for Anxiety. We then compared acute-phase patient characteristics and response to drug treatment. Response was defined as a decrease of at least 40% in the Y-BOCS total score and a rating of "improved" or "very improved" on the Clinical Global Impressions scale within 16 weeks of treatment and maintained over three consecutive evaluations. RESULTS: By the sixth month of treatment, 31 patients (58.5%) responded to either clomipramine or fluoxetine. Nonresponders had lower age at onset and longer duration of the disorder; in addition, they showed higher frequency of compulsions, washing rituals, chronic course, concomitant schizotypal personality disorder, and previous hospitalizations. A worse response to drug treatment was predicted in a stepwise multiple regression by (1) concomitant schizotypal personality disorder, (2) presence of compulsions, and (3) longer illness length. CONCLUSION: Our findings suggest that there are distinct types of OCD with respect to drug treatment response. They provide indirect evidence of treatment specificity by identifying characteristics responsive to different modalities, which may be of value in the selection of patients for alternative treatments.

Adolescent↗
PubMed1995

[Psychological and psychopathological correlates in Dupuytren's disease].

The etiology of Dupuytren's disease, a chronic and depressive lesion of the palmar aponeurosis, is still unclear. Numerous factors have been implicated, including psychopathological elements and a stressor psychosomatic response, possibly in the presence of a personality structure which may represent a diathesis. On the other hand, from a psychosomatic point of view, any psychic correlates could be secondary to somatic damage. In order to look for common psychological and psychopathological elements in the syndrome 39 patients were examined by a team of orthopedics specialised in hand surgery during the period 1990-91. All cases were studied by clinical interview, the evaluation of anamnestic data of possible psychiatric importance and the use of Rorschach and MMPI tests. The data obtained do not confirm that specific personality elements or psychopathological factors can be correlated to the clinical symptoms of Dupuytren's disease given that the results are comparable to what may be considered the characteristics of a non-selected but age- and culturally-matched population. There are only sporadic findings indicating neurotic and depressive factors, or senile involution. Likewise, no reliable and uniform stressing events were observed, or particular signs of maladaptation related to environmental reactivity or the disease itself.

Adult↗
PubMed1994

[The general practitioner and psychiatric assistance. A study carried out in the Piedmont region].

The study examines the relation between the general practitioner, in the Piedmont Region, and the possibility of providing psychiatric assistance (direct prescription of psychopharmacological treatment, psychological interview for generally psychotherapeutic purposes, referral of patient to psychiatric specialist) within the context of out-patient activities. For this purpose a 24-question questionnaire was drawn up and sent to 303 G.P.'s Piedmont whose names were supplied by the Italian Society of General Medicine. One hundred and forty-four GPs returned the answered questionnaire; from an analysis of the replies it emerged that the problems (GP's personal anxiety, lack of specific training, problems of time, payment and diagnosis of psychiatric disorders) concerning the relation between the said GPs and the aforesaid psychiatric assistance have not changed over the past 15 years even in view of the high attendance rate of patients with psychic pathologies and a widespread readiness of the GPs to take personal responsibility for these patients.

Drug Prescriptions↗
PubMed1993

Double-blind study of the efficacy and safety of sertraline versus fluoxetine in major depression.

An eight-week double-blind, multicentre study was performed to evaluate the efficacy and safety of sertraline vs. fluoxetine in the treatment of major depression (DSM-III-R). There were 108 out-patients, from nine Italian centres, entered into the study, of whom 88 were evaluable (48 sertraline, 40 fluoxetine). The final mean daily dose of sertraline was 72 mg and for fluoxetine it was 28 mg. Both treatment groups showed a statistically significant improvement from baseline at one week, and this was maintained until the end of treatment for all of the following measures: Hamilton Rating Scales for Depression and Anxiety, the Montgomery Asberg Depression Rating Scale, Clinical Global Impressions Scale, Zung Self-Rating Scale for Anxiety and the Leeds Sleep Evaluation Questionnaire. Although there was a numerical advantage for sertraline on several efficacy measures, there was no statistically significant difference found between the treatment groups. The incidence of adverse events was similar for both treatments; 40.4% for sertraline and 39.3% for fluoxetine. However, adverse events were generally rated by patients as of lower severity in the sertraline group. In addition, for the fluoxetine group, there was a higher incidence of agitation, anxiety and insomnia than for sertraline. Sertraline was considered to be better tolerated than fluoxetine overall, since only 9.6% of sertraline-treated patients discontinued treatment due to therapy failure whereas in the fluoxetine-treated group this figure was 19.6%. By contrast, 13.5% of sertraline-treated patients discontinued prematurely because of clinical improvement, compared with 10.7% of fluoxetine-treated patients.

1-Naphthylamine↗
PubMed1993

[Generalized anxiety disorder. Clinical and nosological remarks].

The authors review current understanding of generalized anxiety disorder, with particular regard to the clinical description made by the DSM-III-R. Discussion is focused on the validity of the diagnostic criteria of the disorder and on the debate on the nosological position of the illness. The review cites evidence regarding prevalence of the disorder and data on its comorbidity with the other anxiety disorders and with mood disorders. Evidence on intra-episodic, longitudinal and familial co-morbidities are assessed. Aspects of psychopathology of generalized anxiety disorders are also discussed.

Anxiety Disorders↗
PubMed1993

[Rubidium chloride in the treatment of major depression].

The present study evaluated 20 patients (18 females and 2 males: mean age 55 +/- 8.8 years) suffering from major depression who had been treated with 360/720 mg/die rubidium chloride for 60 days. A gradual and significant improvement in depressive symptoms (HDRS and Zung Scale) and anxiety (Stai X1 and HamARS) was reported. Serum levels were not correlated to clinical improvement. Slight adverse effects were also observed (diarrhea and skin rashes). Rubidium chloride showed a marked and rapid anti-depressive action which was particularly evident in relation to mood, anti-conservative ideas, work, occupational interests and psychomotory slowing-down. It is clear that these symptoms represent the most important aspects of the polymorphous depressive syndrome and, in some ways, this improvement should be interpreted as the effective influence of the drug on the biological contest of mood changes.

Chlorides↗
PubMed1992

An analysis of peripheral type benzodiazepine receptors on blood mononuclear cells during high dose steroid treatment of multiple sclerosis.

We report here a study of peripheral type benzodiazepine receptors (pBZr) in mononuclear cells (MNC) from blood of patients with multiple sclerosis (MS) during periods of stable and active disease and from normal controls. Most active MS patients were retested in a longitudinal study, both during a treatment with high dose steroids and while medication free. Active MS produces a significant decrease of receptor density compared with the controls whereas remission of the disease shows no effect. Four weeks of steroid treatment restore binding density to normal levels, and two weeks of drug withdrawal result in a small, but significant increase in number of the binding sites compared with the control value. We suggest that the number of pBZr in blood MNC might change during the clinical course and steroid therapy of MS.

Adult↗
PubMed1991

A study of 3H-PK 11,195 binding to "peripheral-type" benzodiazepine receptors on human lymphocytes. Evidence of decreased binding in hepatic encephalopathy.

In an attempt to assess the involvement of the "peripheral-type" benzodiazepine receptors (pBDZR) in hepatic encephalopathy (HE), we examined the binding of the isoquinoline carboxamide derivative 3H-PK 11,195 to lymphocyte membranes from a group of patients with liver cirrhosis with or without clinical signs of HE and normal controls. Lymphocyte 3H-PK 11,195 binding is saturable, with high affinity and presents the pharmacological specificity corresponding to pBDZR. A significant 40% decrease in the number of 3H-PK 11,195 binding sites, without a concomitant change in the apparent affinity, is observed in the group with HE as compared to the controls, but not in that with liver diseases without HE. The decrease in binding capacity correlates significantly with the clinical grading of HE, but not with age, sex, aetiology of cirrhosis or presence of surgical shunt. In contrast to the reduction of pBDZR, 3H-N-methylscopolamine binding to lymphocyte muscarinic receptors is not affected in HE. These findings are consistent with a role for pBDZR in HE and may stimulate studies of endogenous modulators and pharmacological agents for these receptors in the disease.

Adult↗
PubMed1991

An analysis of lymphocyte 3H-N-methyl-scopolamine binding in neurological patients. Evidence of altered binding in Alzheimer's disease.

Muscarinic cholinergic receptors were analysed in lymphocyte membranes from 35 patients with early (n = 20) and late onset (n = 15) Alzheimer's disease (AD), 86 patients with other neurological disorders and 60 normal controls by the specific binding of 3H-N-methyl-scopolamine (3H-NMS). The number of binding sites of 3H-NMS (Bmax) was significantly decreased both in early and late onset AD groups as compared with age-matched controls, by 54% and 40%, respectively, whereas the apparent binding affinity (Kd) was the same in all disease and control groups. In addition, the average Bmax in early AD was significantly lower than in late AD. The density of the binding of 3H-NMS was also significantly lower in a subgroup of old subjects with Down's syndrome (DS), whereas no changes were found in younger individuals with DS or in patients with Parkinson's disease, whether they were demented or not, multi-infarct dementia, myasthenia gravis or epilepsy. In the AD group, the difference in binding sites was unrelated either to the severity of dementia or disease duration. Treatment of the patients with cholinergic agents did not alter the binding values in any of the examined group. We conclude that the alteration of lymphocyte muscarinic receptors is highly associated with AD, but whether this reflects the central cholinergic deficit in these patients is uncertain.

Adolescent↗
PubMed1991

Peripheral-type benzodiazepine receptors in anxiety disorders.

Peripheral benzodiazepine receptors (pBDZr) were analyzed in lymphocyte membranes from patients with anxiety disorders (generalized anxiety disorder (GAD), n = 15; panic disorder (PD), n = 10; obsessive-compulsive disorder (OCD), n = 18), other mental disorders (n = 40) and 50 healthy controls, by the specific binding of 3H-PK11195. The number of binding sites (Bmax) was significantly decreased in groups with both GAD and OCD as compared with age-matched controls, by 45% and 25% respectively, whereas the binding affinity (Kd) was the same in all disorder and control groups. Conversely, no changes in binding capacity was observed in the other disorder groups and particularly in the one with PD. The abnormality in pBDZr observed in patients with GAD was restored to a normal value after long-term treatment with 2'-chloro-N-desmethyldiazepam, which also coincided with their recovery from anxiety. Our data suggest that the clinical heterogeneity in anxiety disorders might be related to different biological mechanisms and that lymphocyte pBDZr might be useful in demonstrating these differences.

Anti-Anxiety Agents↗
PubMed1990

[Therapeutic treatment of drug dependence during hospital recovery].

The purpose of the research was to ascertain whether hospitalization makes it easier to treat heroin addiction and to what extent. Eighty-six subjects hospitalised in two Turin hospitals were considered. Two different therapeutic protocols were applied. Results obtained are discussed and some interpretation of resulting data are advanced.

Age Factors↗
PubMed1989

[3H]N-methylscopolamine binding to muscarinic receptors in human peripheral blood lymphocytes: characterization, localization on T-lymphocyte subsets and age-dependent changes.

The properties of the binding of the muscarinic receptor ligands, [3H]quinuclidinyl benzilate ([3H]QNB) and [3H]N-methylscopolamine ([3H]NMS) in human mononuclear cells were compared. The binding of [3H]QNB showed a high, non-specific component and lack of saturability in both intact mononuclear cells and preparations of lysed mononuclear cell membranes. Conversely the specific binding of [3H]NMS had a high affinity and was saturable at concentrations greater than 30 nM in both intact and broken cells. Classical muscarinic receptor antagonists displaced specific binding of [3H]NMS binding according to the law of mass action, while displacement curves for pirenzepine and muscarinic agonists were very shallow (nH less than 1), suggesting the presence of more than one subtype of muscarinic receptor on mononuclear cell membranes. Binding studies with [3H]NMS to purified mononuclear cell subpopulations demonstrated that muscarinic binding sites were mainly localized on thymus-derived (T) lymphocytes and large granule lymphocytes. Moreover evidence is presented of an age-dependent increase of the density of muscarinic binding sites on T-lymphocytes. The results are discussed in terms of the usefulness of the binding of [3H]NMS in studying the physiological function of muscarinic receptors on human T-lymphocytes and their possible changes in patients with neurological diseases.

Adult↗
PubMed1989

Oxiracetam in the treatment of primary degenerative and multi-infarct dementia: a double-blind, placebo-controlled study.

A multicentre, double-blind, between-patient study was carried out to evaluate the efficacy and tolerability of oxiracetam (800-mg tablets), in comparison with placebo, each given twice daily for 12 weeks to patients suffering from primary degenerative, multi-infarct or mixed forms of dementia. Efficacy was assessed by the Inventory of Psychic and Somatic Complaints in the Elderly (IPSC-E), administered at entry and after 4, 8 and 12 weeks of treatment, and by the Blessed Dementia Scale and the Newcastle Memory, Information and Concentration Scale (NMICS), administered at the beginning and at the end of the study. Three hundred and seven patients were enrolled, 18 of whom were excluded from the analysis because of violation of the protocol. Two hundred and eighty-nine patients were analyzed (145 m, 144 f, mean age 73 years) and 272 completed the study; 3 patients in each treatment group were withdrawn because of poor tolerability, 10 because of poor compliance and 1 patient because of the occurrence of a cerebral stroke. A significantly (p less than 0.01) different effect, in favor of oxiracetam, was observed in the three main efficacy criteria (i.e. IPSC-E, Blessed Dementia Scale and NMIC total scores), and confirmed by descriptive analyses carried out on some subitems of the scales used. Thirty-one patients on oxiracetam and 27 on placebo complained of a total of 35 and 32 minor unwanted effects, respectively. No clinically or statistically significant changes were observed on routine laboratory examinations.

Aged↗